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遠紅外線治療對末期腎病病人動靜脈廔管功能之統合分析

Effects of Far-Infrared Therapy on the Functional Maintenance of Arteriovenous Fistula in Patients with End-Stage Renal Disease: A Meta-Analysis

摘要


動靜脈瘻管功能不良及失效,會影響末期腎病病人執行血液透析的效率,增加罹病率與死亡率。因此,如何維持瘻管通暢及功能是重要照護議題。本研究以系統性文獻回顧探討遠紅外線照射對瘻管血流量、通暢率及失效率之成效。以關鍵字搜尋中英文次級及初級資料庫,共納入3篇隨機對照試驗及2篇系統性文獻回顧,以Review manager 5.2分析遠紅外線治療之成效,一年後瘻管失效率的勝算比(OR)=0.35, 95% CI [0.22, 0.55], p<.00001;瘻管通暢率OR=2.12, 95% CI[1.44, 3.11], p=.0001;瘻管血流量照射前後之差異,實驗組較控制組在一年後平均差(MD)為129.62ml/min, 95% CI [73.05, 186.18], p< .00001。此結果支持將遠紅外線照射列為瘻管的保養措施之一,應建立儀器操作規範及標準流程,加強病人使用安全。

並列摘要


Malfunction of arteriovenous fistula (AVF) affects patients with end-stage renal disease and increases the rates of morbidity and mortality. Therefore, maintenance of AVF patency is a crucial concern. The objective of this systematic review was to explore the effectiveness of far-infrared therapy on AVF blood flow, patency, and malfunction. Chinese and English secondary and primary databases were searched using relevant keywords; subsequently, three randomized controlled trials (RCTs) and two systematic review studies were shortlisted. Data from the three RCTs were included in the meta-analysis, pooled and evaluated using Review Manager 5.2. The pooled odds ratio (OR) for AVF malfunction and AVF patency were 0.35 (95% confidence interval (CI) [0.22, 0.55], p<.00001), and 2.12 (95% CI [1.44, 3.11], p=.0001), respectively; blood-flow velocity mean difference (MD) was 129.62mL/min, (95% CI [73.05, 186.18], p<.00001) after 1 year in the experimental group. The findings support previous results that revealed improvement in fistula maintenance through far-infrared therapy. Establishing operational procedures and standards increased patient safety.

參考文獻


林娥朱、簡惠眞、蔡秋月、陳素娥、陳進堂(2006).某區域醫院腎臟病人血液透析效率之影響因素分析.醫保研究雜誌,2(1),31-38。
岳芳如、柯乃熒、顏妙芬(2014).以系統性文獻回顧探討遠紅外線維護血液透析病人自體動靜脈瘻管之成效.護理雜誌,61 (6),78-86。
賴麗英、蕭淑惠、李仁慈、楊惠美、陳建文(2010).血液透析病人動靜脈瘻管使用年限與 PTA 治療之分析.腎臟與透析,22 (3),210-215。
Bashar, K., Healy, D., Browne, L. D.,Kheirelseid, E. A., Walsh, M. T., ClarkeMoloney,M., ... Walsh, S. R. (2014). Role of far infra-red therapy in dialysis arteriovenous fistula maturation and survival:Systematic review and meta-analysis. Public Library of Science , 9(8), e104931.
Lin, C. C., Chang, C. F., Lai, M. Y., Chen, T.W., Lee, P. C., & Yang, W. C. (2007). FarInfrared therapy: A novel treatment to improve access blood flow and unassisted patency of arteriovenous fistula in hemodialysis patients. Journal of the American Society of Nephrology, 18(3),985-992.

被引用紀錄


謝秋蓮、鍾玉珠(2021)。一位末期腎臟病人初次接受血液透析之護理經驗彰化護理28(3),91-103。https://doi.org/10.6647/CN.202109_28(3).0011

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